People infected with Chagas disease (CD), a parasitic condition caused by the protozoan Trypanosoma cruzi, are more vulnerable to manifesting severe symptoms of covid-19 and are listed as a priority group for vaccination against Sars-CoV-2 .
In a report published by the World Health Organization, on the occasion of the commemoration of World Chagas Disease Day, which takes place every April 14, the importance of caring for the more than 6 million people infected with it was highlighted. the parasite, most of them located in Latin America.
Since the coronavirus pandemic began in late 2019, science has proven that the most common symptoms of COVID-19 are associated with heart disease, including arrhythmias, cardiomyopathy and acute heart injury, coagulation disorders including thromboembolism and pulmonary embolism, disseminated intravascular coagulation, hemorrhage, and arterial clot formation.
In the case of chronic Chagas disease, it usually produces prothrombotic states, cardiac alterations and secondary thrombotic cerebrovascular accidents, which will undoubtedly affect a patient infected with both diseases to a greater extent, who will run the risk of presenting the most serious symptoms of covid- 19.
Although Chagas disease is an endemic pathology in 21 countries of the American continent, the migrations of infected people can take it to non-endemic countries, since its main form of transmission is vectorial, through hemiptera or bedbugs, which infect people exposed to its sting, by depositing their infected feces in skin wounds or on mucous membranes. Other forms of transmission can occur through congenital transfusion, organ transplants, or by mouth.
People infected with CD present a period of between 15 to 40 days of parasite incubation and the acute phase of the disease usually lasts one to two months and then falls into an indeterminate phase, as no clinical symptoms are observed.
When a patient is diagnosed with CD, some develop a chronic form of the disease with complications in the cardiovascular and gastrointestinal systems, have severe symptoms such as stroke, and covid-19 interacts with the cardiovascular system on multiple levels.
During the chronic phase, the parasites remain hidden mainly in the heart and digestive muscle and over time the infection can cause sudden death from cardiac arrhythmias or progressive heart failure as a consequence of the destruction of the heart muscle.
In a work presented by Global Heart -a platform for the dissemination of public health programs in the area of cardiovascular diseases- it is detailed that covid-19 is a risk for those with CD because both diseases are exposed to cardiac diagnosis added to other risk factors such as diabetes and obesity that are also prevalent in people with CD.
Covid-19 reactivating potential of CD. The investigations of the consequences that both diseases can generate in a patient have not yet been scientifically totalized. However, there is concern that COVID-19 could reactivate Chagas disease in people who suffered from it but who later did not register more clinical symptoms.
In the Global Heart report, it is explained that CD by activating gastrointestinal and other cardiac complications increases susceptibility to the coronavirus. Therefore, the concern of those who control the health sector in the world directs their attention to Latin America where CD is endemic and the pandemic increasingly affects the countries of the region. The head of PAHO's Neglected and Vector-Borne Infectious Diseases Unit, Luis Gerardo Castellanos, specified that EC vector control was stopped, so 2020 was challenging for countries that tried to maintain their efforts against Chagas.